• Title/Summary/Keyword: mental drowsy

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A Case of Adenocarinoma of the Lung Associated with Multi-oragn Infarctions (다발성 장기 경색을 동반한 폐선암 1례)

  • Park, Chang-Whan;Lee, Chung-Hoon;Whang, Jun-Wha;Jang, Il-Gwon;Park, Hyeong-Kwan;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1177-1183
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    • 1997
  • The relationship between neoplastic disease and thromboembolic disorders has been recognized since 1865, when Armand Trousseau first reported a high incidence of venous thrombosis in a series of patients with gastric carcinoma. The overall incidence of thromboembolic disease in patients with cancer has been reported to vary 1% to 15%. In a prospective study, Ambrus and associates reported that thrombosis and/or bleeding was the second most common cause of death in haspitalized cancer patients. We report a case who presented as a thromboembolic disease and subsequently confirmed to have an underlying lung malignancy. This 45 years old male patient visited our hospital with abdominal pain and distention of 3 days duration. Abdominal CT scan revealed multiple splenic and renal infarctions. On 20th haspital day, drowsy mental status was developed and hemorrhagic cerebral infarction was noted in brain CT scan. Chest CT scan revealed a 4cm sized spiculated mass on left lung apex and multiple paratracheal lymph adenopathy. With surgical biopsy of left supraclavicular lymph nodes, this patient was confirmed to have adenocarcinoma.

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Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease A Case Report -A Case Report- (관상동맥질환을 동반한 대동맥류 수술치험 1례)

  • 우종수;서정욱
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.724-728
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    • 1997
  • We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

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A Case of Internal Myiasis of the Repiratory System Associated with Pneumonia (폐렴과 병발된 호흡기계의 내부 승저증(internal myiasis) 1례)

  • Choi, Eu-Gene;Lim, Dong-Mee;Na, Moon-Jun;Yang, Jong-Myeung;Lee, Young-Ha;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.650-655
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    • 2002
  • Internal myiasis is a rare disease, which has not been reported in Korea, yet. This case report describes a patient with pneumonia associated with internal myiasis. She was 84-year old female who was admitted to the emergency department, Konyang University Hospital as a result of dyspnea and fever and a drowsy mental state. Approximately twenty fly maggots continuously crawled out from the nose at the third hospital day in the intensive care unit. These maggots were almost 7.2mm long and were identified as the genus lucilia belonging to the family Calliphoridae. In addition, a bronchial washing study showed eggs of the dipterous larvae. A lesion of this myiasis case might have been located in the respiratory system of patient. This case is the first internal myiasis of the respiratory system reported in Korea. This cases is discussed with a review of the relevant literature.

Relationship Between Subjective Fatigue Symptoms, Body Type and Health Awareness in Middle School Students (중학생의 피로자각증상과 체형 및 건강의식과의 관련성에 관한 연구)

  • Song, In Soon;Cho, Young Chae
    • Journal of the Korean Society of School Health
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    • v.10 no.2
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    • pp.169-178
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    • 1997
  • In order to investigate the complaint rates of subjective fatigue symptoms and study the relationship between them and body type, health awareness in middle school students, we carried out a survey of 1,209 students (654 boy students and 555 girl students) at a middle school in Taejon City by a self-recorded questionnaire. The survey was conducted in June, 1997. The results obtained were as follows: 1. Among complaints of fatigue, "feel like lying down" was the highest, followed by "feel anxious about things", "feel drowsy", "yawning a lot", "eye strain" and "whole body feels tired" in descending order. 2. In the average weighted score of fatigue complaint, dullness and sleepiness (I) was the highest, followed by a difficulty in concentration (II) and bodily projection of fatigue (III) in descending order. Fatigue seems to create mental stress rather than physical burdens. 3. In the classification of body type based on the $R\ddot{o}hrer$ index, the obesity type (145 and above) was 11.0%, standard type (110~144) was 64.7% and leptosomic type (l09 and below) was 24.3%. Comparison between both sexes revealed that the rate of obesity and leptosomic types were significantly higher in boy students than in girl students. 4. In terms body type awareness, the statistics are the following: those who consider themselves to be standard type, 44.3%, slightly obese 24.5%, leptosomic, 23.5% and obese 7.8%. However, the level of obesity awareness was significantly higher in girl students than in boy students. 5. As for health awareness, 36.5% considered themselves healthy, 5.4% generally healthy and 10.1% a little unhealthy, but the level of unhealthy awareness was higher in girl students than in boy students. 6. In the relationship between body type and health awareness, most students thought that they were obese in spite of their standard body type. Also, many students who were obese and leptosomic tended to consider themselves to be a little unhealthy. 7. The more the students were obese or felt unhealthy, the more the average weighted score of fatigue complaints was high.

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Industrial Fatigue and Low Back Pain of the Nurses in General Hospital (종합병원 간호사들의 피로자각증상과 요통)

  • Kim, Soon Lae;Cho, Tong Ran
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.2
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    • pp.162-168
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    • 1999
  • To investigate industrial fatigue and low back pain, the questionaire survey for subjective symptoms of fatigue and low back pain was carried out 305 nurses in general hospital in Korea. Nurses participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionaires. The subjective sysptoms of fatigue comprised three groups of 10 items each, representing dullness and sleepiness(level of cerebral activation), difficulty in concentration(level of motivation) and bodily projection of fatigue. The resultant data were processed for $x^2$-test, t-test to confirm the associations. The results were as follows: 1. 28 items of fatigue subjective symptoms exept two item, 'feel thirsty and 'feel ill', were directly associated with low back pain. 2. The percentage of fatigue complaint were significantly higher in LBP group than control. 3. Of the 30 items of fatigue subjective symptoms, the highest percentage was accounted for 'legs feel heavy', 'eye strain', 'feel stiffness in the neck or the shoulders' followed by 'feel like lying', 'whole body feels tired', 'feel a pain in the low back', 'feel drowsy' and in the order of sequence. 4. The average weighted score for the first group of fatigue items(dullness and sleepiness) was the largest among three groups and was followed by the second group(difficulty in concentration) and the third group (bodily projection of fatigue) in the order of sequence, suggesting the heavier mental and shift work stress of the female workers.

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A Case of Successful Resuscitation of 10,150 J Shocks and Therapeutic Hypothermia on Aconitine-induced Cardiovascular Collapse (10,150 J의 심장조율동과 치료적 저체온법으로 소생한 중증 초오 중독 환자 1례)

  • Moon, Hyung Jun;Lee, Jung Won;Kim, Ki Hwan;Jeong, Dong Kil;Kim, Jong Ho;Kim, Young Ki;Lee, Hyun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.97-101
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    • 2014
  • Aconitine, found in the Aconitum species, is highly extremely toxic, and has been known to cause fatal cardiac arrhythmias and cardiovascular collapse. Although several reports have described treatment of aconitine intoxication, management strategy for the patient in a hemodynamically compromised state who experienced cardiopulmonary collapse is unknown. We report here on a case of a successful cardiopulmonary resuscitation and therapeutic hypothermia in an aconitine-induced cardiovascular collapsed patient. A 73-year-old male who presented with nausea, vomiting, chest discomfort, and drowsy mental state after eating an herbal decoction made from aconite roots was admitted to the emergency department. He showed hemodynamic compromise with monomorphic ventricular tachycardia resistant to amiodarone and lidocaine. After 3 minutes on admission, he collapsed, and cardiopulmonary resuscitation was initiated. We treated him with repeated cardioversion/defibrillation of 51 times, 10,150 joules and cardiopulmonary resuscitation of 12 times, 69 minutes for 14 hours and therapeutic hypothermia for 36 hours. He recovered fully in 7 days.

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Rapid Progression to Brainstem Encephalitis Caused by Enterovirus 71 Without Throat and Skin Lesions After a One-Day Fever

  • Kyung Min Kim;Soo Yeon Kim;Mi Kyoung Song;Ji Young Kim;Anna Cho;Ji Young Park
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.91-96
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    • 2023
  • Infection with enterovirus (EV) 71 is usually associated with hand-foot-and-mouth disease and herpangina. The most frequent neurologic complication is brainstem encephalitis. A 30-month-old boy visited the pediatric emergency department with fever, lethargy, and abnormal eye contact. His mental status was slightly drowsy. On hospitalization day 2, the patient experienced respiratory arrest with apnea. Brain magnetic resonance imaging revealed bilateral symmetric T2-high signal lesions without enhancement in the posterior aspect of the brainstem and left medial temporal lobe. Electroencephalography was indicative of diffuse cerebral dysfunction with diffuse high amplitude and irregular delta activities. He underwent a gene study and was diagnosed with myoclonic epilepsy with ragged red fibers syndrome. We report a case of EV 71 brainstem encephalitis by polymerase chain reaction for nasopharyngeal aspirates and feces with rapid progression within one day of fever without the manifestation of throat and skin lesions because of his underlying mitochondrial disease.

A Clinical Study of Acute Carbon Monoxide Intoxication (급성 일산화탄소 중독증 환자의 임상적 고찰)

  • Choi, Kyong-Chan;Park, Mee-Yeung;Hah, Jung-Sang;Byun, Yeung-Ju;Park, Choong-Suh
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.86-97
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    • 1991
  • To obtain the basic data of prognosis of acute carbon monoxide(CO) intoxication, one hundred and sixteen cases of CO intoxication defined by carboxyhemoglobin(COHb) and admitted via emergency room of Yeungnam University Hospital from Oct. '85 to April' 89 have been clinically analyzed and evaluated, including delayed postanoxic encephalopathy(DPE) and the following results were obtained. 1. The ratio of male to female was 1:1.5 and mental state was drowsy mostly(26.2% of 116 cases) 2. The more disturbed the mental state, the more decreased was the arterial pH and $PaCO_2$, which may be the result of metabolic acidosis. 3. The early laboratory findings in patients of CO intoxication were as follows : leukocytosis-65.5%, increase of hematocrit-23.3%, hyperglycemia-19.8%, increase of GPT-19.8% increase of creatinine-0.9%, and glucosuria-12.1%. 4. The early findings of EKG were abnormal in 35.3% : change of rhythm-25.0%, abnormal ST segment-15.5% (change of rhythm and abonormal ST segment-5.2%) but the conduction disorder was not present. 5. The abnormal EEG above mild degree was 93.1%, of which moderate was most frequent(80.2%). 6. The incidence of DPE was 7.8% among all admitted CO patients. DPE cases had long duration of exposure time(8 hours), severe leukocytosis(20,000) and an abnormal EEG(MA).

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Fatigue Subjective Symptoms and Risk Factors in Bank Workers with VDT (VDT작업 은행원들의 피로자각증상 조사)

  • Lee, Kyung-Jae;Kim, Joo-Ja
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.45-52
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    • 2005
  • Objectives : To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. Methods : A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. Results : Mean age was $35.8{\pm}7.2$ years ($38.9{\pm}6.0$ in males, $30.6{\pm}5.8$ in females), Mean work duration was $7.7{\pm}7.1$ years ($8.4{\pm}7.4$ in males, $6.5{\pm}6.4$ in females). Mean symptom score in males was $11.0{\pm}8.1$ ($4.9{\pm}3.1$ in Group I, $3.0{\pm}3.1$ in Group II, $3.1{\pm}2.8$ in Group III) and in females was $17.5{\pm}9.5$ ($7.0{\pm}3.8$ in Group I, $4.6{\pm}3.5$ in Group II, $5.9{\pm}3.4$ in Group III). Mean scores were higher in the order of Group I>III>II. Females had significantly higher scores than males in all three groups (p<0.001). Most common symptoms complained of as 'always' or 'sometimes' were feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking'(54.2%) among Group II, and 'feel stiff in the shoulders (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. Conclusions : More supportive VDT work environment and education for correct work postures for VDT workers are recommended.

A Clinical Analysis of Pneumonia in Acute Drug Intoxication (급성 약물 중독환자에서 발생된 폐렴의 임상양상 및 위험인자에 대한 고찰)

  • Yoon, Hyun Ju;Son, Ji Woong;Choi, Eu Gene
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.380-388
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    • 2005
  • Background : Acute drug intoxication has recently become an important issue in the social and clinical areas. There are various complications associated with acute drug intoxication such as pneumonia, but the process is was not fully understood. The aim of this study was to analyze our cases of pneumonia associated with acute drug intoxication and to determine the associated risk factors. Methods : Forty four cases out of 237 patients, who were acute drug intoxicated from May 2000 to Feb. 2005, were diagnosed with pneumonia at the Konyang University hospital. These cases were analyzed by a retrospective review of their medical records. Results : The incidence of pneumonia in acute drug intoxication was 18.6%. There was no gender difference in terms of the incidence, but the age group with the highest incidence was in the $5^{th}$ decade (22.5%) followed by the $7^{th}$ decade (17.9%). Most common drug of associated with pneumonia was organophosphate insecticides, and the others were herbicides. Suicidal attempts were the most common motive of intoxication. The incidence of pneumonia was increased in old age (${\beta}=0.128$, p<0.05). A drowsy or comatous mental status was an independent risk factors of pneumonia (${\beta}=-0.209$, p=0.006). A longer hospital duration was also a risk factor for pneumonia (${\beta}=0.361$, p<0.001). The intubated state, intensive care unit care and longer duration of admission correlated with the course of pneumonia in acute drug intoxicated patients (p<0.05). The culture study revealed MRSA to be most common pathogen. Conclusion : The incidence of pneumonia associated with acute drug intoxication was higher in the older aged patients, those with a decreased initial mental status and a longer hospital duration. The number of days in the intensive care unit and intubation were associated prognostic factors for pneumonia in acute drug intoxication patients.